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Nicole McCroary – Finding My Inner Leader during the COVID-19 Pandemic

Reflecting on the Nightingale Challenge Northern Ireland Global Leadership Development Programme: Finding My Inner Leader during the Covid-19 Pandemic

Nicole McCroary, Staff Midwife, Labour Suite, Altnagelvin Hospital

My name is Nicole McCroary and I graduated from Edinburgh Napier University in 2016 as a qualified midwife, aged 18 years. I have been working in Altnagelvin Hospital for five years now, during this time I have gained a wide range of experience, working on Antenatal, Postnatal and Delivery Suite. I currently work on the Delivery Suite; this is definitely where my passion lies. I receive tremendous satisfaction from being part of a professional, friendly team, who are always ready to support women at this important time. I feel truly privileged every time I am part of bringing new life into the world. Not every day is easy, but I hope that every day I make a difference, no matter how small.

For the majority of women, pregnancy can be a wonderful experience, however, for some women it can also come with worries and concerns that require the support and interventions from midwives. As well as supporting women in labour, my current role involves a wider range of responsibilities such as supporting Band 5 midwives in their transition to working independently as qualified midwifes; supporting students on placement; completing monthly audits and I am also a ‘haemovigilance assessor’ for midwifery and medical staff.

In 2018 I was nominated by my line manager for an award at the Nursing and Midwifery Awards Ceremony held by the Western Trust. I was delighted to be awarded the ‘Rising Star Award’ at Band 5 level. On receipt of the award, my line manager described me as a ‘natural leader’ and I then knew that I wanted to further develop my leadership skills and was delighted when the opportunity to be a participant on the Nightingale Challenge Northern Ireland Global Leadership Development Programme (NCNI GLDP) presented itself. I felt very honoured to be one of thirty young nurses and midwives from across Northern Ireland to be selected for the opportunity. Initially my aim of being on the programme was to develop my personal leadership skills, however it has in fact brough far more opportunities and insights than I had imagined. Since commencing on the Programme, I have completed a series of Institute for Healthcare Improvement (IHI, USA) modules and the United Nations Sustainable Development Goals (SDG) Primer Certificate. I have also had the opportunity to engage with some of the most successful leaders within the nursing and midwifery professions both locally and globally, including meeting Professor Fran McConville, Lead Midwife, World Health Organisation (WHO), and by Zoom, Elizabeth Iro, Chief Nursing Officer, WHO. Neither would I every have dreamt of engaging with. Networking with both senior and young nursing and midwifery leaders has been so valuable and provided rich learning. Specifically, I have had the opportunity to engage with my peers from various trusts in Northern Ireland as well as global peers, known as our Global Associates. I have learned that, despite working within the same field, we all work so differently – collectively these insights have enhanced the way I work in my day-to-day role as they sparked ideas for change through the learning and sharing opportunities. I am convinced that using the leadership skills and confidence developed through my participation on the NCNI GLDP has also helped me to inspire and motivate the students I work alongside.

Recently, as part of the NCNI GLDP, I was assigned to a group of four midwives to complete a ‘60-day Challenge’ in which we had to come together to create a combined piece of work detailing five ways in which the NCNI GLD programme gave us ‘a voice to lead’. It was very thought provoking to hear what elements of the programme others had used to enhance their practice. I also believe my communication skills have positively evolved from being part of the NCNI GLDP, especially when I am in high-pressured situations. From the IHI modules, which are underpinned by global ‘improvement science’ methodologies, I learned that most leaders under-communicate, by a factor of 10. This particularly resonated with me, so I strived to work on my communication skills, as I recognised, they are key to maintaining safety of the women and babies in my care. In my view, a good leader needs to role model good communication skills, if they are to motivate and influence the team they lead.

When the NCNI GLDP was launched in January 2020 we did not anticipate that we would be completing the programme during a global pandemic. As Covid-19 swept its way across the world, our programme was turned on its head. The Programme leader, Dr. Catherine Hannaway had to work very quickly to change the way the programme would be provided; using technology solutions like Zoom and setting up WhatsApp and a private Facebook group. This in itself is an excellent demonstration of leadership by Dr. Catherine Hannaway, an amazing role model to aspiring young leaders like myself. One positive taken from the Covid-19 pandemic is that we have probably had more opportunity to engage with NCNI GLDP participants and leaders from all corners of the globe via zoom, which still feels such a privilege.

Within obstetric and maternity services, we have also had to adapt our ways of working in order to continue to care for women during the pandemic. As maternity services could not pause or decrease services in any way, we had to adapt new policies and procedures quickly. This was a very daunting time. I personally struggled with the introduction of many forms of mandatory Personal Protective Equipment (PPE), mainly because I felt it would de-personalise the care I was providing to women, making it difficult to build trusting relationships. However, I knew I had to remain resilient and motivated to ensure appropriate safe care was provided for pregnant women. The learning from the NCNI GLDP helped me with these challenges. As a team we came together for a weekly safety briefing, where all new changes were discussed, and any issues could be raised. The Western Health and Social Care Trust (WHSCT) also provided very good psychological support to staff during this time in the form of free helplines, increased chaplaincy services and telephone counselling sessions. Dr Ed Sipler, a specialist behavioural psychologist and therapist from South East Health and Social Care Trust, discussed with us how to look after our mental health and the mental wellbeing of our colleagues during the continuing pandemic. Ed provided some amazing resources for our own personal use and resources that we as leaders could pass on to colleagues. Ed said ‘count your daily blessings’ which is more important now than ever.

Early in the NCNI GLDP I also had the pleasure of attending a session by Brian Dolan, Professor of Leadership in Healthcare. Brian said, “If people believe what you believe, they will follow you”. He explained how leaders need to be passionate about why they want to achieve something when engaging their workforce. Brian also encouraged us to ‘put energy into things you can change’. Brian’s words have inspired me throughout my quality improvement project which I am undertaking within my workplace as an essential component of the programme. We were provided with excellent teaching surrounding quality improvement. Namely, by Brenda Carson, Senior lead nurse for Patient Safety and Quality Improvement (SEHSCT) and Maggie Morgan Cooke, Senior Improvement Facilitator. Brenda said, “We don’t always get it right as a system”, indicating why quality improvement work is essential within healthcare. Due to the insights Brenda and Maggie were able to provide, completing IHI modules, support from Dr. Catherine Hannaway and my colleagues within the WHSCT, my project when completed will see improvements made to the care provided to women who have an epidural in labour, which in turn will enhance patient safety.

I would like to thank Dr. Catherine Hannaway for facilitating such relevant, inspiring leaders to impart their wisdom on to us. Also, Professor Charlotte McArdle, Chief Nursing Officer, Department of Health, Northern Ireland, Mary Frances McManus and the team, and particularly Dr Dale Spence, Lead Midwifery Officer, Northern Ireland who has really ‘walked-the talk’ in role-modelling her passion and care for developing the next generation of leaders of midwifery services in Northern Ireland. Having learned about global issues that affect us all, including now knowing about the WHO and the International Confederation of Midwives, has widened my global interest. I look forward to the forthcoming publication of the ‘State of the World’s Midwifery Report’ and joining in the celebrations of the 2021 International Day of the Midwife.

Rodney Morton, Executive Director of Nursing and Allied Health Professionals, Public Health Agency, Northern Ireland, in his presentation at one of the NCNI GLDP workshops quoted from a global survey that ‘nurses and midwives are the most trusted professions’ and described how we need to use this to our advantage in terms of promoting good health and health lifestyles in particular. Therefore, going forward I really do intend to ‘make every contact count’. My passion for midwifery services continues to develop and I remain committed and driven about maintaining high standards of intrapartum care provided to women. I hope in future I will continue to have many more opportunities to improve patient safety and satisfaction in relation to maternity health services.